Question:

Why do the Explanation of Benefits you send me for my child's orthodontic work and the bills the orthodontist send me not match up?

Answer:

This could occur if your provider gave us one set of payment arrangements to pay our liability and provided you with another set of payment arrangements to pay your liability. For example, on a total case of $4,300, we may be reimbursing $1,500 (at a rate of $800 down and $150 per month). The payment arrangements the provider made with you may be based on the remaining $2,800 that is your responsibility.